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Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity.

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Summary

Accessory soleus muscle (ASM), a rare ankle variant, can cause pain and mimic tumors or tarsal tunnel syndrome. This study highlights a case presenting without swelling, emphasizing the need for accurate diagnosis and treatment.

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Area of Science:

  • Anatomy
  • Radiology
  • Orthopedics

Background:

  • Accessory soleus muscle (ASM) is a rare anatomical variant.
  • It often presents as painful posteromedial ankle swelling.
  • ASM can mimic soft tissue tumors and tarsal tunnel syndrome (TTS).

Observation:

  • Two cases of ASM are presented.
  • Case 1: Typical painful swelling, diagnosed via MRI, treated with resection.
  • Case 2: Atypical presentation with pain and paresthesia, no swelling, initially misdiagnosed and mistreated.

Findings:

  • The second case is the first reported instance of symptomatic ASM without posteromedial swelling.
  • This atypical presentation may be due to a proximally positioned ASM belly.
  • Accurate diagnosis is crucial to differentiate ASM from other conditions.

Implications:

  • Highlights the importance of considering ASM in differential diagnoses for ankle pain, even without swelling.
  • Emphasizes the role of advanced imaging and expert interpretation in diagnosing rare conditions.
  • Proper diagnosis and treatment, including tarsal tunnel decompression when necessary, can resolve symptoms.